目 的 探讨MR灌注加权成像 (PWI)在鉴别脑胶质瘤复发中的价值。方 法 选取2014年2月至2016年1月在我院治 疗的48例胶质瘤患者，放疗后进行影像 随访，行常规MR及PWI检查。结果 48例 胶质瘤患者，复发30例，放射性脑损伤 18例；肿瘤复发组强化形态呈结节样和 最大强化宽度≥5mm的比例分别为76.67% 和80.00%，均明显高于放射性脑损伤组 (P＜0.05)；肿瘤复发组强化形态呈地图 样比例为10.00%，明显低于放射性脑损 伤组(P＜0.05)；肿瘤复发组相对脑血容 量(rCBV)和相对脑血流量(rCBF)分别为 2.12(1.02-4.81)和1.90(0.81-4.60)， 明显高于放射性脑损伤组(P＜0.05)； 肿瘤复发组和放射性脑损伤组相对平均 通过时间(rMTT)差异比较无统计学意义 (P＞0.05)。结论 常规MR增强扫描和PWI 检查在鉴别脑胶质瘤复发中有一定的价 值，其中PWI可提供rCBV、rCBF、rMTT等 参数，为脑胶质瘤患者复发及放射性脑 损伤鉴别诊断提供依据。

Objective To investigate the value of MR perfusion weighted imaging (PWI) in the diagnosis of recurrence of glioma. Methods 48 patients with glioma treated in our hospital from February 2014 to January 2016 were selected and followed up by radiotherapy, then underwent routine MR and PWI examination. Results There were 30 cases of recurrence in the total 48 cases of glioma, 18 cases had radiation brain injury; the proportion of nodular enhancement forms was 76.67% and the maximum enhancement width is greater than or equal to 5 mm ratio was 80% in the recurrence group, which were significantly higher than that of radiation brain injury group (P<0.05), the ratio of map enhancement was 10%, which was significantly lower than that of the radiation brain injury group (P<0.05). The relative cerebral blood volume (rCBV) and relative cerebral blood flow (rCBF) in the tumor recurrence group were 2.12 (1.02-4.81) and 1.90 (4.60-0.81), respectively, and were significantly higher than those in the radiation brain injury group (P<0.05). There was no significant difference in the relative mean transit time (rMTT) between tumor recurrence and radiation brain injury group (P>0.05). Conclusion Conventional MR enhanced scan and PWI scan in the diagnosis of brain glioma recurrence has certain value, in which PWI can provide objective indicators.